Virgina medical center

Recently, I made a site visit to Virginia Mason Medical Center (VMMC), Seattle, WA, as part of the process of determining its designation by the National Association For Continence (NAFC) as a Center of Excellence in Continence Care. I never expected to find myself hearing about car manufacturing philosophies. But VMMC has adopted the Toyota Production System (TPS) — known in this country as lean manufacturing — and applied it to the pursuit of the perfect patient experience. VMMC CEO Gary Kaplan, MD, has equated the process of perfecting car production with perfecting patient care services throughout his institution.1 In doing so, he and the health system’s leadership have successfully placed the patient at the center of VMMC’s universe.

The transformation began when patient safety was threatened because the organization’s process of delivering services, in quality control terms, was faulty. Lives were being lost and financial assets were eroding. The institution’s image and brand were severely marred, jeopardizing the entity’s existence. Ironically, now nearly a decade after implementing this program, leaders from prominent Japanese hospitals are visiting VMMC to see how it has applied the principles of TPS to healthcare to learn how they might improve their own institutions.

Throughout America’s healthcare system, we risk losing sight of why we exist because we may “discount” the patient or render him/her invisible — ie, absent from view, priority, or consideration. Virginia Mason put the patient back in the equation, right at the top of the pyramid from which the institution’s vision, mission, values, strategies, and foundational elements emanate. As a result, VMMC’s organizational attitudes about safety, waste, and management practices now revolve around the patient’s best interests, needs, and satisfaction. During my visit, I was struck by how in harmony everyone was in speaking about patient care. No one has rank above the patient and anyone can